Newspaper article St Louis Post-Dispatch (MO)

Rating Hmos for Quality

Newspaper article St Louis Post-Dispatch (MO)

Rating Hmos for Quality

Article excerpt

What is the best HMO for getting you into your doctor's office when you're sick?

Can you tell which plan has the most conscientious doctors or is quickest with referrals to specialists? Which plans just can't seem to keep their members and which ones can?

At least one book seeks to answer those and other HMO quality questions. The $12 Consumers Guide to Health Plans relates the opinions of 72,000 federal workers asked to rate their HMOs. The plans represent about three-fourths of all U.S. HMO enrollment.

If you buy the numbers, some Missouri and Illinois HMOs scored pretty well in customer satisfaction. But look beyond the obvious and a few show weaknesses.

Nine Missouri plans and 17 Illinois plans were included in the national survey. They include such well knowns as BlueChoice, GenCare, Group Health Plan, MetraHealth (doing business as MetLife) and Partners HMO. Consumers rated the plans on a scale of 1 to 5 - 1 means "poor," " 3 means "good, and 5 is "excellent."

Nationally, 89 percent rated plans "good" to "excellent." Ten of the 26 Missouri and Illinois plans exceeded that, with a 92 percent rating or better.

Physicians Health Plan scored highest, with a 97 percent satisfaction rating. Physicians is being combined with GenCare Health System into what is now called United Healthcare - Midwest, St. Louis' largest HMO company.

MetLife and Partners (owned by BJC Health System and managed by Aetna) were second highest, scoring 94. Health Alliance HMO, serving east central and western Illinois, also scored a 94.

Even the lowest patient satisfaction scores here weren't that bad. BlueChoice scored 88, one point below national average. In Illinois, BCI HMO, serving downstate counties, scored 87.

The survey, conducted by the Gallup organization in 1995, also asked HMO members if they would recommend their plan to a friend. On average, less than half said they would.

In Missouri and Illinois, most plans scored better. Physicians scored highest again, with 63 percent saying yes, followed by Partners and MetraHealth. …

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